Ophthalmopathy in thyroid disease
A b s t r a c t: Thyroid associated orbithopathy (ophtalmopathy) - TAO is an autoimmune disease of the thyroid gland and orbit, which is closely associated with Graves' hyperthyreoidism, though either condition may exist eithout the other.It may antedate, coincide with or follow Graves disease. The frequency of the associated depends on the method used for detecting TAO. With very sensitive methods subclinical form can be demonstrated in 50-80% of patients with hyperthyroidism.The clinical features of TAO vary from mild form to severe diplopia, loss of vision and disfiguring proptosis. The review summarizes the existing literature and discusses of the most widely used forms of treatment for TAO such glucocorticoids and other immunosuppressive agents ( cyclosporin, cyclophosphamide, azothioprin, methotrexate). Simatostatin analogues ( octreotide and lanreotide), may provide a valuable, though costly, therapeutic alternative to steroid therapy. Orbital radiotherapy has been used in the menagement of TAO i many country for almost 60 years.
Therapeutic options range from topical lubricants to systemic corticosteroids, radiation and orbital surgery.